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Socioeconomic inequalities and Black/White disparities in US cocaine-involved overdose mortality risk

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Abstract

Purpose

This study examined whether socioeconomic inequalities account for Black/White disparities in: (a) the prevalence of potential risk factors for overdose among adults using cocaine; and (b) national mortality rates for cocaine-involved overdose.

Methods

Data from 2162 Non-Hispanic (NH) Black or White adults (26 +) who reported past-year cocaine use in the 2015–2019 National Survey of Drug Use and Health were analyzed to obtain predicted probabilities of potential overdose risk factors by race and sex, using marginal effects via regression analyses, adjusting for age and socioeconomic indicators. Next, National Center for Health Statistics data (for 47,184 NH Black or White adults [26 +] who died of cocaine-involved overdose between 2015 and 2019) were used to calculate cocaine-involved overdose mortality rates by race and sex across age and educational levels.

Results

Several potential overdose vulnerabilities were disproportionately observed among NH Black adults who reported past-year cocaine use: poor/fair overall health; cocaine use disorder; more days of cocaine use yearly; hypertension (for women); and arrests (for men). Adjusting for age and socioeconomic indicators attenuated or eliminated many of these racial differences, although predicted days of cocaine use per year (for men) and cocaine use disorder (for women) remained higher in NH Black than White adults. Cocaine-involved overdose mortality rates were highest in the lowest educational strata of both races; nonetheless, Black/White disparities were observed even at the highest level of education, especially for adults ages 50 + .

Conclusion

Age and socioeconomic characteristics may account for some, yet not all, of Black/White disparities in vulnerability to cocaine-involved overdose.

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Funding

This work was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health [Award Number K01AA026645; PI: Christopher P. Salas-Wright]. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIAAA or the NIH.

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Authors and Affiliations

  1. Department of Social Work, University of Texas at San Antonio, 501 W. César E. Chávez Blvd., San Antonio, TX, 78207, USA

    Manuel Cano & Dora Hernandez

  2. School of Social Work, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA

    Christopher P. Salas-Wright

  3. Department of Public Health Sciences, Division of Prevention Science & Community Health, University of Miami, Miami, FL, USA

    Christopher P. Salas-Wright

  4. College of Social Work, The Ohio State University, 1947 College Rd, Columbus, OH, 43210, USA

    Sehun Oh

  5. Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA

    Lailea Noel

  6. School of Social Work, St. Louis University, 3550 Lindell Blvd, St. Louis, MO, 63103, USA

    Michael G. Vaughn

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  1. Manuel Cano
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Correspondence to Manuel Cano.

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Cano, M., Salas-Wright, C.P., Oh, S. et al. Socioeconomic inequalities and Black/White disparities in US cocaine-involved overdose mortality risk. Soc Psychiatry Psychiatr Epidemiol 57, 2023–2035 (2022). https://doi.org/10.1007/s00127-022-02255-5

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